Orthodontic possibilities for young patients with missing maxillary incisors

In the orthodontic treatment of young patients with missing maxillary incisors one should make an effort to avoid prosthetic solutions. This not only applies to situations with agenesis of maxillary lateral permanent incisors, but also to those cases in which maxillary incisors cannot be maintained after trauma. Standard solutions are presented for various sagittal jaw relationships and types and number of teeth missing. Specific rules have to be observed for the closure of spaces due to missing teeth in order to reduce the occurrence of papillae retraction and to place the substituting teeth in such a position that their crowns can be built up to look like the originals. This requires mesiodistal angulations that deviate from the standard ones, a proper distribution of crown width and in most cases a permanent retention with a palatally bonded thin multistranded wire.